Individual
DR. AIDAN N PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Contact information
Practice address
3443 RENNER RD STE 100, PLANO, TX 75074-0051
(214) 572-8633
(214) 572-8638
Mailing address
3443 RENNER RD STE 100, PLANO, TX 75074-0051
(214) 572-8633
(214) 572-8638
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
23584
TX
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
23584
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BP1-0022848
INSTITUTIONAL PERMIT
—
Enumeration date
06/09/2007
Last updated
02/12/2025
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